Evidence map›Paper›PMID 39431966›Full record

SynthesisEpilepsia2024

Effectiveness of antipsychotic drug therapy for treating psychosis in people with epilepsy: A systematic review.

Aryan Arora, Priya Prakash, Laura Rizzo, Graham Blackman, Anthony S David, Jonathan P Rogers

Abstract readSystematic Review
In one paragraph

Synthesis in Epilepsia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Aryan AroraMedical School, University College London, London, UK.ORCID https://orcid.org/0000-0002-6029-1677
Priya PrakashDivision of Biosciences, University College London, London, UK.ORCID https://orcid.org/0009-0001-0352-3689
Laura RizzoDivision of Biosciences, University College London, London, UK.ORCID https://orcid.org/0009-0007-8716-863X
Graham BlackmanDepartment of Psychiatry, University of Oxford, Oxford, UK.
Anthony S DavidInstitute of Mental Health, University College London, London, UK.
Jonathan P RogersDivision of Psychiatry, University College London, London, UK.

Funding

Laidlaw FoundationNational Institute for Health and Care ResearchWellcome TrustWellcome Trust 220659/z/20/z
6 · The paper itself

Abstract

Individuals with epilepsy are at risk of developing preictal, ictal, postictal and interictal psychoses. Antipsychotic drugs (APDs) are the main class of drugs used to treat psychosis and schizophrenia. The efficacy and safety of APDs as a treatment for epileptic psychosis is not well understood. This systematic review aimed to assess the effectiveness and adverse effects of APDs for treating psychosis in people with epilepsy. We adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched MEDLINE, Embase, PsycInfo, and AMED (Allied and Complementary Medicine) from database inception to June 20, 2023. We contacted experts in the field and performed citation searches to identify additional records. Title, abstract, full-text review, and data analysis were conducted in duplicate, with conflicts resolved by discussion among authors. Given the considerable heterogeneity of study designs, meta-analysis was not deemed appropriate; instead, the results were tabulated in a narrative synthesis. The Joanna Briggs Institute Risk of Bias tool and GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework were used to assess study quality. We identified 13 studies with a total of 1180 participants. In the four case series included, the psychotic symptoms of 25 of 28 patients treated with APDs partially improved or fully resolved. Three of the four cohort studies reported an association between antipsychotic use and longer duration of psychotic episodes, two found similar results in both APD and non-APD groups, and two did not report control psychosis outcomes. When reported, seizure frequency was observed to remain unchanged or decrease following APD treatment. The evidence on the effectiveness of antipsychotics in the treatment of psychosis in epilepsy is inconclusive and may reflect confounding by indication. However, most studies suggest that antipsychotics were not associated with a marked worsening in seizure frequency. It remains unclear whether antipsychotics should be used in epilepsy, and well-controlled cohort studies and randomized controlled trials are necessary to draw definitive conclusions.

Indexed as

Antipsychotic AgentsEpilepsyPsychotic DisordersHumansTreatment OutcomeAntipsychotic Agentsantipsychoticepilepsypsychosisseizuresystematic review

Identifiers

PMID39431966
PMCPMC11647423

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.